Healthcare Provider Details

I. General information

NPI: 1922110378
Provider Name (Legal Business Name): PITTSBURG CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SCHOOL ST
PITTSBURG CA
94565-3937
US

IV. Provider business mailing address

1355 WILLOW WAY
CONCORD CA
94520-5723
US

V. Phone/Fax

Practice location:
  • Phone: 925-432-3831
  • Fax:
Mailing address:
  • Phone: 925-808-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number48118723
License Number StateCA

VIII. Authorized Official

Name: ALBA TILLER
Title or Position: PRESIDENT
Credential:
Phone: 925-808-6540